1 Axillary - Interpectoral (Rotter's) nodes - Nodes along the axillary vein and its tributaries2 Supraclavicular3 Internal mammary - Nodes in the intercostal spaces along the edge of the sternum in the endothoracic fascia

If there is a 4.0-cm intraductal component and a 0.3-cm invasive component, what would be the pathologic tumor classification?

T1a since the pathologic tumor size for the T component is a measurement of only the invasive component.

What is microvasion of breast carcinoma?

Microinvasion is the extension of cancer cells beyond the basement membrane into the adjacent tissues with no focus more than 0.1cm in greatest dimension.

When there are multiple foci of microinvasion, the size of only the largest focus is used to classify the microinvasion.

What is inflammatory carcinoma of the breast?

Inflammatory carcinoma is a clinicopathologic entity characterized by diffuse erythema and edema (peau d'orange) of the breast, often without underlying palpable mass. Should involve the majority of the skin of the breast.Should NOT be applied to the patient with neglected locally advanced cancer presenting late in the course of her disease.Staged at T4d.

What are micrometastases?

Tumor deposits greater than 0.2mm but not greater than 2.0 mm in largest dimension that may have histologic evidence of malignant activity, eg, proliferation or stromal reaction.

JCO 2005244 patients with stage I/II s/p lumpectomyRandomized1: Adj doxorubicin-based chemo followed by RT2: Adj RT followed by 4 cycles of same chemoAt 11 years follow-up- No differences in OS, DM, time to any event, or site of first failure- For close margins, crude LR was 32% (chemo first) vs 4% (RT first)- For positive margins, crude LR was 20-23% in both arms.

In the Danish Breast Cancer Cooperative Group 82B Trial (DBCG 82B), 1708 women who underwent mastectomy for pathologic stage II or III breast cancer were randomly assigned to one of the following two arms:1) 8 cycles of chemotherapy plus chest wall

7

The Early Breast Cancer Trialists Collaborative Group meta-analysis included approximately 40 randomized trials that evaluated the efficacy of post-mastectomy radiation therapy.

########

This meta-analysis found an absolute reductio

True

The Early Breast Cancer Trialists Collaborative Group meta-analysis included approximately 40 randomized trials that evaluated the efficacy of post-mastectomy radiation therapy.

What was the relative reduction in the locoregional recurrence ra

67%

In which level of the axilla is a breast cancer patient most likely to recur following a modified radical mastectomy and an axillary lymph node dissection? Level I Level II Level III

Level III

A breast cancer patient is treated with mastectomy and adjuvant chemotherapy. If she develops an isolated locoregional recurrence, where is she most likely to fail?

Rank the following sites from most likely to least likely (i.e. type 1 by the

1 Chest Wall2 Supraclavicular Nodes3 Axilla

A 58 year old woman presents with a mass in the upper outer quadrant of the left breast. The mass is biopsied and pathology returns infiltrating ductal carcinoma.

She elects to have a mastectomy and axillary lymph node dissection. Margins are

All listed except cervical.

What is the risk for locoregional recurrence following mastecomy for a patient with T2N1 infiltrating ductal carcinoma? 2 out of 10 lymph nodes were positive. (MD Anderson retrospective review) <5% 15% 25% 35%

15%

According to the 2001 NCI Consensus Conference, post-mastectomy radiation therapy should be recommended for ... all patients. patients with 1 or more positive lymph nodes. patients with 2 or more positive lymph nodes. patients with 3

Patients with 4 or more positive lymph nodes.

Let's assume that a new chemotherapy is found to reduce mortality from 5% to 4%. The absolute reduction in mortality is 1%. What is the relative reduction in mortality? 10% 20% 40% 60% 80% 90%

20%

In the Danish Breast Cancer Cooperative Group 82C Trial (DBCCG 82C), 1375 women, who underwent mastectomy for pathologic stage II or III breast cancer, were randomly assigned to one of the following two arms:1) 30 mg Tamoxifen2) 30 mg Tamoxif

In the Danish Breast Cancer Cooperative Group 82C Trial (DBCCG 82C), 1375 women, who underwent mastectomy for pathologic stage II or III breast cancer, were randomly assigned to one of the following two arms:1) 30 mg Tamoxifen daily for one year

In the British Columbia Trial, 318 patients were enrolled in the study after undergoing modified radical mastectomy and axillary lymph node dissection. Patients were then randomized to one of the following arms:

1) Chemotherapy alone2) C

Premenopausal Women 1 or more positive axillary nodes

In the British Columbia Trial, 318 patients were enrolled in the study after undergoing modified radical mastectomy and axillary lymph node dissection. Patients were then randomized to one of the following arms:1) Chemotherapy alone2) Chemoth

There was a stat sig improvement in DFS and breast CSS, but no stat sig improvement in OS.

Which chemotherapy agents were used in the DBCCG 82B and British Columbia Trials? Adriamycin and cyclophosphamide Adriamycin, cyclophosphamide, and taxotere Cyclophosphamide and 5FU Cyclophosphamide, methotrexate, and 5FU

Cyclophosphamide, methotrexate, and 5FU

A 35 year old female presents with a diffusely edematous and erythematous left breast. The skin is warm, but there are no palpable nodules. The breast has the classic "peau d'orange" appearance.

What finding establishes the diagnosis

Tumor emboli are seen in the dermal lymphatics.

A patient is diagnosed with inflammatory carcinoma of the breast. What treatment do you recommend first? Radiation Therapy Mastectomy Systemic Chemotherapy Hormonal Therapy

Systemic Chemotherapy

According to the current American Cancer Society screening guidelines, at what age should women begin screening mammography? 30 35 40 45 50 55 60

40

What is a woman's lifetime risk for developing breast cancer? 17% (1 in 6) 12% (1 in 8) 10% (1 in 10) 8%(1 in 12)

12% (1 in 8)

Approximately what percent of all women diagnosed with breast cancer will die from breast cancer? 10% 30% 50% 70% 90%

30%

Using the Gail Model, you determine that your patient has a 15% lifetime risk for the develoment of breast cancer.

According to the NCI recommendations for MRI screening, this patient should have annual screening mammography and breast MRIs.

False

What percent of all breast cancers have a major inherited component (i.e. BRCA-1 or 2, p53, PTEN, or ATM mutations)? 10% 33% 50% 67% 90%

10%

What percent of heritable breast cancers have a BRCA-1 mutation present?

Choose the closest answer. 10% 33% 50% 67% 90%

50%

What percent of women with a BRCA-1 mutation will develop breast cancer over the course of their lifetime (i.e. what is the penetrance of the BRCA-1 mutation for the development of breast cancer)? 10% 33% 50% 67% 90%

90%

Development of what cancer other than breast cancer is associated with the presence of a BRCA-1 germ line mutation? Pancreatic Cancer Glioma Sarcoma Leukemia Ovarian Cancer

Ovarian

Which of the following is considered a risk factor for the development of breast cancer? Multiparity Early menopause Breastfeeding Early menarche Exercise

Early menarche

The level I axillary lymph nodes are located ... ? Lateral to the Pectoralis Minor Beneath the Pectoralis Minor Medial to the Pectoralis Minor

Lateral to the Pectoralis Minor

If the level I and II axillary lymph nodes are negative, what percent of the time are the level III axillary lymph nodes positive? < 5% 10% 20% 30%

< 5%

Which of the following is the most common histologic subtype of invasive breast cancer? Medullary Carcinoma Tubular Carcinoma Mucinous Carcinoma Lobular Carcinoma Ductal Carcinoma

A 28 year old woman with cT2N0M0 infiltrating ductal carcinoma (LVI present, ER/PR negative, Her-2-Neu positive) is a candidate for breast conservation therapy. True or False

True

A patient is diagnosed with breast cancer. Which of the following is the most important prognostic factor for this patient's overall survival? Histologic Subtype Hormone Receptor Status Margin Status Lymph Node Status A

Lymph Node Status

Margin status is a major criterion for breast conservation therapy. Negative margins should be the goal for all patients.

The definition of an acceptable negative margin is somewhat controvertial.

According to Dr. Jacobson and most

2 mm

In order for a breast cancer to be considered EIC+ (EIC: extensive intraductal component), DCIS must comprise at least what percent of the tumor? 10% 25% 50% 75% 90%

25%

EIC (extensive intraductal component) positive breast cancers are associated with an increased risk for postive margins and an increased risk for local recurrence following breast conservation therapy. True or False

True

Radiation oncologists should be familiar with these randomized trials comparing mastectomy alone and breast conservation therapy:

The EORTC and Lyon trials support the use of a boost following whole breast radiation therapy.

Both trials report what absolute reduction in the local recurrence rate with a boost? <3% 5% 10% 25% 33%

<3%

Regarding treatment planning for whole breast radiotherapy:

An isocentric technique is typically used. The collimators are rotated to define the deep edge of the radiation field.

The deep edges of the medial and lateral tangent fi

Coplanar

A patient with T1 N0 infiltrating ductal carcinoma comes to you for whole breast radiotherapy as part of her breast conservation therapy.

A calc point is placed near the chest wall. What dose will you most likely prescribe to that calc point?

50.4 Gy / 28 fxs

What is the most common late effect following breast conservation therapy? Brachial Plexopathy Lymphedema Radiation Pneumonitis Carcinogenesis Rib fractures Cardiac Toxicity

Lymphedema

Which of the following is the most common radiation-induced malignancy in patients who received whole breast radiation therapy? Lung Cancer Leukemia Contralateral Breast Cancer Lymphangiosarcoma

Lung Cancer

What number of axillary lymph nodes removed for sampling during a level I/II node dissection for breast cancer most likely would require postoperative radiation therapy to the axilla? A) 2 B) 6 C) 8 D) 10

A) 2

Which of the following factors is the most important predictor of disease-free survival and overall survival in patients with breast cancer? A) Tumor size B) Mitotic index C) Axillary lymph node status D) Hisopathologic tumor

C) Axillary lymph node status

For the following trials, what is the correct isolated locoregional failure rate over a 10-year period for a premenopausal patient with one to three positive lymph nodes who receives postmastectomy chemotherapy and tamoxifen with no radiation therapy? NS

Danish trial (82b), 30%

Which of the following treatment outcomes is associated with patients who have DCIS, according to prospective randomized trials? A) IN NSABP B-17, the actuarial rate of breast cancer recurrence after 12 years in patients who received surgery only

B) In NSABP B-17, the actuarial rate of breast cancer recurrence after 12 years in patients who received surgery plus breast irradiation was 16%.

Which of the following pathological stages of breast cancer is associated with a patient who has a 5.0-cm primary tumor and 12/15 positive, non-fixed lymph nodes? A) pT3N2 B) pT3N3 C) PT2N1 D) pT2N3

D) pT2N3

Which of the following statements associated with the postmastectomy Danish trials investigating the use of radiation therapy is true? A) The trials studied the use of anthracycline chemotherapy for all premenopausal patients. B) The trials

D) The trials found an association between the use of radiation therapy and reduced rates of subsequent development of metastatic disease.

Which of the following statements about breast cancer in men is true? A) The tumor is most commonly ER-positive. B) The disease should be treated with cisplatin-based chemotherapy. C) The majority of patients who undergo genetic scre

A) The tumor is most commonly ER-positive.

Which of the following adjuvant systemic therapies would be most appropriate to recommend for an otherwise healthy patient who has HER-2/neu-positive (FISH) ER/PR_negative breast cancer with positive axillary lymph nodes? A) Four cycles of dose-de

B) Four cycles of AC, four cycles of paclitaxel with concurrent trastuzumab, and continuation of trastuzumab for 1 year

Which of the following statements about patients who are diagnosed with breast cancer and have supraclavicular lymph node involvement is true? A) The diagnosis should be classified as stage M1 breast cancer. B) Approximately 30% of patients

D) Over 20% of patients will survive 10 years with aggressive trimodality therapy.

Which of the following statements about level III involvement of the axillary lymph nodes in a patient with breast cancer is true? A) This region is immediately lateral to the infraclavicular fossa. B) The region is superomedial to the pect

B) The region is superomedial to the pectoralis minor muscle and lateral to the clavicular bone.

Which of the following statements about the diagnosis of inflammatory breast cancer is true? A) There may not be a discrete palpable mass at presentation. B) At presentation, a patient may report having a longstanding breast mass that devel

A) There may not be a discrete palpable mass at presentation.

Which of the following statements about metastasis of breast cancer to the bone is true? A) Metastasis to the epidural spine is most commonly associated wtih worsening back pain in the supine positionn or with the Valsalva maneuver. B) Comp

A) Metastasis to the epidural spine is most commonly associated wtih worsening back pain in the supine positionn or with the Valsalva maneuver.

Which of the following radiation treatment sites would be most appropriate for a patient with breast cancer who undergoes postoperative irradiation after successful wide excision for a localized chest wall recurrence 2 years after mastectomy and chemothe

B) Chest wall and draining lymph nodes

Which of the following findings is associated with a better outcome for patients who have a local recurrence of breast cancer after breast-conserving surgery? A) Metaplastic histology B) A disease-free interval of <2 years C) Recu

C) Recurrent DCIS in a different quadrant of the breast

Which of the following statements about the treatment of bone metastases secondary to breast cancer is true? A) Radiation therapy will achieve partial or complete pain relief within 4 weeks. B) Single-fraction irradiation provides equivalen

The NSABP and EORTC completed randomized trials that compared neoadjuvant chemotherapy against adjuvant chemotherapy. In these trials, what percentage of patients who initially were not candidates for breast conservation therapy underwent this procedure

C) 21-30%

A 30-year-old non-Ashkenazi woman is diagnosed with breast cancer. Her family history is significant for a mother with breast cancer at age 50. There is no history of ovarian cancer in her family. Her estimated probability of having a BRCA1 or BRCA2 muta

B) 10%-25%

The probability of an isolated supraclavicular lymph node recurrence in a patient with a 2.5 cm lateral breast tumor and 2/18 positive axillary lymph nodes is which one of the following? A) 3-5% B) 6-10% C) 11-15% D) 16-20%

A) 3-5%

For the following type of breast cancer, select the one lettered feature that is MOST closely associated with it:

For the following type of breast cancer, select the one lettered feature that is MOST closely associated with it:

Metaplastic carcinoma A) Can contain cartilage and other connective tissue elements B) Is associated with contralate

A) Can contain cartilage and other connective tissue elements

NSABP B-06 trial A) Twenty-year results demonstrated an improvement in overall survival when radiation was given after lumpectomy and axillary dissection. B) Found the tamoxifen after radiation decreased ipsilateral breast events for women w

E) Found the 20-year ipsilateral breast recurrence rate for patients treated with lumpectomy, axillary dissection and radiation +/- chemotherapy to be 14%

NSABP B-04 trial A) Twenty-year results demonstrated an improvement in overall survival when radiation was given after lumpectomy and axillary dissection. B) Found the tamoxifen after radiation decreased ipsilateral breast events for women w

C) Suggested that axillary recurrences after no primary axillary treatment are not associated with poorer overall survival

NSABP B-21 trial A) Twenty-year results demonstrated an improvement in overall survival when radiation was given after lumpectomy and axillary dissection. B) Found the tamoxifen after radiation decreased ipsilateral breast events for women w

D) Demonstrated that radiation reduces ipsilateral breast recurrences in patients with tumors less than 1cm with negative lymph nodes treated with surgery and tamoxifen

Concerning HER2/Neu: It is a tumor suppressor gene located on chromosome 18. True or False

False - it's on long arm of 17

Concerning HER2/Neu: It is amplified in 20 - 30% of all breast cancers. True or False

True

Concerning HER2/Neu: Is associated with resistance to particular systemic treatments True or False

True

Concerning HER2/Neu: Is a member of the Epidermal Growth Factor Receptor family True or False

Concerning the Danish 82b and 82c clinical trials evaluating postmastectomy radiation: Both demonstrated radiation improved overall survival only in the patients with 4 or more positive lymph nodes. True or False

False

Concerning the Danish 82b and 82c clinical trials evaluating postmastectomy radiation: For the patients randomized to irradiation, the internal mammary lymph nodes were included in the treatment fields. True or False

True

Concerning the Danish 82b and 82c clinical trials evaluating postmastectomy radiation: After 10 years, there was no difference in cardiac-related mortality or morbidity. True or False

Concerning the Danish 82b and 82c clinical trials evaluating postmastectomy radiation: The Danish 82b study demonstrated that those treated with radiation had a statistically significant improvement in both local-regional control and overall survival.

True

The single most important risk factor for the development of female breast cancer is which one of the following? A) Parity B) Cyclical estrogen exposure (age at menarche/menopause) C) Postmenopausal estrogen replacement therapy

According to the Oxford Overview of Randomized Adjuvant Chemotherapy Trials: The optimal duration of adjuvant chemotherapy is 3 - 6 months. True or False

True

According to the Oxford Overview of Randomized Adjuvant Chemotherapy Trials: The absolute reduction in the risk for recurrence with polychemotherapy in women under the age of 50 years was 10% in node-negative and 15% in node-positive patients. True

True

According to the Oxford Overview of Randomized Adjuvant Chemotherapy Trials: The absolute reduction in mortality in women under the age of 50 years with the use of adjuvant chemotherapy was 6% in axillary node-negative and 12% in axillary node-positive p

True

According to the Oxford Overview of Randomized Adjuvant Chemotherapy Trials: In women aged 50 - 69 years, the absolute reduction in mortality was 15% in axillary node-positive patients. True or False

False

According to the Oxford Overview of Randomized Adjuvant Chemotherapy Trials: The absolute benefit offered by use of an anthracycline-based chemotherapy regimen over CMF was approximately a 2% improvement in outcome measures. True or False

True

Regarding the application in treatment and/or prevention of bone metastases secondary to breast carcinoma: Both samarium and strontium are most effective in patients with diffuse osteoblastic disease. True or False

True

Regarding the application in treatment and/or prevention of bone metastases secondary to breast carcinoma: Strontium has less myelosuppression than samarium. True or False

False

Regarding the application in treatment and/or prevention of bone metastases secondary to breast carcinoma: There is little additional benefit derived from use of external beam irradiation to regions of significant tumor burden irrespective of correlative

Regarding the application in treatment and/or prevention of bone metastases secondary to breast carcinoma: The rationale for use of adjuvant bisphosphonates in patients with operable breast carcinoma is based on studies, which show a significant reductio

True

According to data from the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-21 trial, the estimated annual risk of a breast recurrence for a postmenopausal woman with a T1 N0 breast cancer treated with lumpectomy, breast radiation, and tamox

A) 0.5% per year

According to data from the Harvard Nurses' Study, which one of the following lifestyle variables was associated with the greatest relative risk for developing breast cancer? A) High-saturated-fat diet vs. low-fat diet B) Smoking 1 pack of c

C) Moderate/high alcohol use vs no alcohol use

Benefits of neoadjuvant chemotherapy compared with adjuvant chemotherapy include all of the following, EXCEPT: A) Permits breast conservation for selected patients who initially would be required to have mastectomy B) Reduces the rates of di

B) Reduces the rates of distant metastases by delivering chemotherapy earlier in the treatment course

Which one of the following is the respective incidence of local regional recurrence after breast conservation therapy vs mastectomy at 20-year follow-up according to NSABP B-06? A) 8% vs 6% B) 13% vs 6% C) 13% vs 15% D) 8 % vs

D) 8 % vs 15%

Which one of the following is the median time to local recurrence at the primary site after breast conservation therapy? A) 1.5-2 years B) 3-4 years C) 5-6 years D) 7 or more years

B) 3-4 years

Which one of the following is the time interval when MOST "elsewhere" failures (outside the quadrant of the primary lesion) occur? A) 1.5-2 years B) 3-4 years C) 5-6 years D) 7 or more years

D) 7 or more years

For the following clinical trial, select the one lettered answer that describes the observed rate of axillary failure in the clinically negative axilla with no axillary lymph node dissection that is MOST closely associated with it:

NSABP B-04<

A) 20%

For the following clinical trial, select the one lettered answer that describes the observed rate of axillary failure in the clinically negative axilla with no axillary lymph node dissection that is MOST closely associated with it:

Danish Brea

B) 20%

For the following clinical trial, select the one lettered answer that describes the observed rate of axillary failure in the clinically negative axilla with no axillary lymph node dissection that is MOST closely associated with it:

With respect to the phase 3 clinical trials that compared adjuvant aromatase inhibitors with tamoxifen for patients with non-metastatic breast cancer: Adjuvant Arimidex (anastrazole) increased the risk of thrombo-embolic events compared with tamoxifen

False

With respect to the phase 3 clinical trials that compared adjuvant aromatase inhibitors with tamoxifen for patients with non-metastatic breast cancer: Adjuvant Arimidex (anastrazole) increased the risk of osteoporosis relative to tamoxifen True or

True

With respect to the phase 3 clinical trials that compared adjuvant aromatase inhibitors with tamoxifen for patients with non-metastatic breast cancer: After completion of 2 to 3 years of tamoxifen, switching therapy to exemestane improved relapse-free su

True

With respect to the phase 3 clinical trials that compared adjuvant aromatase inhibitors with tamoxifen for patients with non-metastatic breast cancer: After 5 years of adjuvant tamoxifen, additional treatment with Femara (letrozole) improved relapse-free

True

With respect to the Danish 82b postmastectomy radiation trial: All patients were treated with doxorubicin chemotherapy True or False

False

With respect to the Danish 82b postmastectomy radiation trial: Radiation led to an absolute survival advantage of 9% at 10 years True or False

True

With respect to the Danish 82b postmastectomy radiation trial: The improvement in locoregional recurrence associated with radiation was limited to patients with 4 or more positive lymph nodes True or False

False

With respect to the Danish 82b postmastectomy radiation trial: Radiation use was associated with an increased risk for a cardiovascular event True or False

False

With respect to the Danish 82b postmastectomy radiation trial: The median number of lymph nodes recovered from the axillary surgery was 7 True or False

Regarding bilateral breast cancer: In the Oxford overview meta-analysis, there was a 47% reduction in the observed rate of contralateral breast cancer among women treated with 5 years of adjuvant tamoxifen therapy True or False

Concerning the finding of occult axillary micrometastases: The yield of IHC (immunohistochemical)-detected micrometastases is greater for ductal than lobular cancers True or False

False

Concerning the finding of occult axillary micrometastases: IHC detection, with or without the use of serial sectioning, is not superior to H & E/serial sectioning alone for the detection of micrometastases True or False

False

Which of the following recommendations about current clinical management of lobular carcinoma in situ (LCIS) is true? A) Negative surgical margins are necessary when LCIS alone is detected. B) The presence of LCIS with a coexisting invasive

The NSABP B-17 and EORTC trials for ductal carcinoma in situ (DCIS) have NOT demonstrated which of the following outcomes for patients receiving excisional biopsy with or without whole-breast irradiation? A) The annual rate of invasive recurrence is 0.5%

D) More than 60% of recurrences are invasive after excision alone.

Which of the following statements about the use of boost therapy after whole-breast irradiation as part of conservation therapy for early-stage breast cancer is FALSE? A) The EORTC-60 trial demonstrated a 5-year ipsilateral breast recurrence rate

D) Boost dose escalation can improve long-term control rates when surgical margins are less than 1 mm.

Which of the following factors is most important in determining an acceptable cosmetic outcome for patients who have undergone breast-conserving therapy for breast cancer? A) Volume of resection B) Quadrant of the primary tumor C) Co

A) Volume of resection

Which of the following factors is not associated with an increased risk of locoregional recurrence after a patient undergoes breast-conserving therapy or mastectomy without radiation therapy? A) Tumor size B) Number of involved axillary lym

B) Number of involved axillary lymph nodes

Which of the following findings is not an absolute contraindication to irradiation of the breast as part of conservation therapy? A) Pregnancy B) Collagen vascular disease C) Prior irradiation to the ipsilateral breast D) Multicentri

B) Collagen vascular disease

The International Breast Cancer Study Group (IBCSG) evaluated risk factors for locoregional recurrence after mastectomy and chemotheraopy without irradiation in over 5,000 patients treated in seven prospective trials. Which of the following situations is

What percentage of patients with locally advanced breast cancer would be expected to have no residual disease in either the breast or lymph nodes after four cycles of neoadjuvant anthracycline-based chemotherapy? A) <5% B) 10% C)

C) 15% to 20%

Which of the following statements about the NSABP B-18 trial, which compared neoadjuvant to adjuvant chemotherapy, is true? A) Patients receiving neoadjuvant chemotherapy had improved relapse-free survival. B) Patients receiving adjuvant ch

D) Over 50% of the patients were candidates for breast-conserving therapy at the time they enrolled in the trial.

Which of the following statements about pathological complete response (pCR) after neoadjuvant chemotherapy administered for breast cancer is true? A) The estimated long-term survival of patients who achieve pCR is improved compared to the estimat

A) The estimated long-term survival of patients who achieve pCR is improved compared to the estimated survival predicted at diagnosis.

Which of the following statements about the epidemiology of advanced breast cancer is true? A) While rates of ductal carcinoma in situ (DCIS) have increased, rates of advanced breast cancers have remained constant B) In the year 2000, approximatel

Which of the following statements about the meta-analysis of radiation therapy performed by the Early Breast Cancer Trialists' Collaborative Group (EBCTCG) is true? A) Radiation therapy was associated with an increased risk for cardiovascular deat

A) Radiation therapy was associated with an increased risk for cardiovascular death.

A 42-year-old patient has inoperable, 5-cm axillary lymph node recurrence of breast cancer 2 years after undergoing mastectomy and adjuvant doxorubicin-based chemotherapy for stage II breast cancer. Which of the following statements about htis patient sc

D) The treatment of choice is neoadjuvant taxane-based chemotherapy, reassessment for operability, and irradiation of the subsequent chest wall and regional lymphatics.

Which of the following statements about the HER2/neu gene expression is true? A) It is a tumor suppressor gene. B) It encodes for a cellular receptor with a tyrosine kinase domain. C) It can be identified by cytokeratin immunostainin

B) It encodes for a cellular receptor with a tyrosine kinase domain.

Which of the following scenarios is most appropriate for a diagnosis of inflammatory breast cancer? A) A patient has erythema and edema that have developed over a large area of the breast during a 1 week period, but no palpable mass. Fine-needle a

C) A patient feels a mass in the breast. Over the next 2 weeks, the skin over half of the breast becomes erythematous and edematous. Biopsy reveals ductal carcinoma.

Which of the following statements about the diagnosis of inflammatory breast cancer is true? A) Pathologic disease confirmation is unnecessary since inflammatory breast cancer is a clinical diagnosis. B) The dermal lymphatic system needs to

C) Approximately 50% of patients do not have a palpable mass at the time of diagnosis.

Which of the following treatments is most appropriate for patients who have a poor Karnofsky performance status, chemorefractory metastatic breast cancer, and multiple brain recurrences after undergoing whole-brain radiation therapy? A) Gamma knif

B) Hospice care for comfort measures

Which of the following statements about the use of FDG PET scans in the detection of bone metastases secondary to breast cancer is FALSE? A) PET scans demonstrate more sites of metastatic bone lesions than do positive bone scans. B) PET sca

D) PET scans can be used routinely as the sole diagnostic modality for the detection of both osseous and nonosseous metastases.

Which of the following statements about the treatment of bone metastases secondary to breast cancer is FALSE? A) Patients treated with Samarium-153 can experience pain relief within 1 week, and a subjective response can persist for 16 weeks after adminis

Which of the following findings does NOT support a diagnosis of brachial plexus syndrome due to recurrent or metastatic breast cancer rather than a late complication of radiation therapy? A) Motor weakness typically involves the muscles innervated

A) Motor weakness typically involves the muscles innervated by the upper plexus alone or by both the upper and lower plexus.

A patient has a single, mobile, and suspicious axillary lymph node. Which of the following pathologic classification stages of breast cancer is most appropriate after the patient undergoes initial mastectomy and has pathologic findings of disease in nine